某院79项临床医学教学研究课题分析

Analysis of 79 Clinical Medical Teaching Research Topics in a Hospital

目的 通过对79项医学教学研究课题汇总分析探讨临床医学教学研究课题涉及的相关伦理学问题。方法 收集某医科大学教学医院2012年1月1日-2021年7月31日期间申报立项的医学教育教学研究课题共79项,以2019年医院开始承担本科生与全科医学研究生临床教学工作划分为2012-2018年与2019-2021年2个阶段。按照项目总数、级别、研究对象、分类分别统计分析。结果 在项目级别与研究对象方面,2阶段无明显差异(P>0.05),但第2阶段临床教学项目比例大幅度提高到(54.72%,29/53),与第1阶段(15.38%,4/26)比较差异有统计学意义(P<0.01)。第2阶段研究对象涉及学生项目84.91%(45/53)较第1阶段的46.15%(12/15)明显增多(P<0.01);同一班级采用相同教学方式的比例第1阶段为33.33%(3/9),第2阶段为57.78%(26/45);涉及患者及/或病案资料的项目共28项;第2阶段床边教学项目20项均接受了伦理审查,但有4项未提交面向间接参与者的知情同意书,仍有7项课题任务书没有设立“示教病例”纳入标准。结论 医学教学研究课题的重点大部分转向面向学生的临床教学,采用的教学研究方式更趋合理,重视了伦理审查,但仍有部分课题在间接参与者的知情同意与纳入标准方面亟待重视与改进。

Objectives This study aims to discuss the related ethical issues involved in clinical medical teaching research topics through the summary analysis of 79 medical teaching research topics. Methods This study collected a total of 79 medical education and teaching research projects declared by a medical university teaching hospital from January 1, 2012 to July 31, 2021. The hospital began to undertake clinical teaching for undergraduates and general practice postgraduates, which was used as a criterion to divide the topics into two stages: 2012-2018 and 2019-2021.Statistical analysis was performed according to the total number of projects, grades, research objects,and categories. Results There was no difference between the project level and the subjects in the two stages(P>0.05).But the proportion of clinical teaching projects in the second stage greatly increased to 54.72%(29/53), which was significantly different from that in the first stage(15.38%, 4/26). Compared with the number of student projects,which was 46.15%(12/15), in the first stage, the number of student projects in the second stage increased significantly to 84.91%(45/53)(P<0.01).The proportion of the same class adopting the same teaching method was 33.33%(3/9) in the first stage and 57.78%(26/45) in the second stage. There were 28 items involving patients and/or medical records.All 20 second-stage bedside teaching projects underwent ethical review, but 4 did not submit informed consent for indirect participants. There were still 7 project task books that did not set the inclusion criteria for "teaching cases". Conclusions With the change of teaching objects, the focus of medical teaching research projects has mostly shifted to student-oriented clinical teaching, and the adopted teaching research methods have become more reasonable, with an emphasis on ethical review. However, there are still some projects that need to be emphasized and improved in terms of informed consent and inclusion criteria of indirect participants.